Medical Exercise: The New Modality

Medical Exercise Training…. The New Modality

Presented by: Dr. Michael K. Jones, PhD, PT.

1.888.610.0923 | postrehab.com

Mandate for Change• Changes in the health care and insurance industries have

mandated the use of exercise as a strong component of the medical management of chronic diseases

• The actual integration of exercise protocols and guidelines into health care management is limited

• Medical Exercise Training is a new concept to deliver protocol based exercise programming for clients with medical conditions

Medical Exercise Training Institute | www.postrehab.com | 1.888.610.0923

Wasted Billions• Diabetes affects 25.8 million Americans at a cost of $245 billion.

• Type II diabetes is easily managed with diet and exercise.

• Hypertension affects 67 million Americans at a cost of $93.5 billion. • Hypertension is easily managed with exercise and diet guidelines.

• Low Back Pain (LBP) – 80% of Americans will experience (LBP). • Total cost of care related to LBP is estimated at $100 billion for 2010. • Surgical procedures to manage LBP: 1) laminectomy and 2) spinal fusion add $15.6 billion.• A structured progressive exercise program can control some of these costs.

• Osteoarthritis (OA) 409,000 hospitalizations occur due to OA. • 27 million Americans suffer with OA with primary involvement in the spine, hip

and/or knee. Annual cost is estimated at $89.1 billion.

• Total hip and knee replacements (TJR) Osteoarthritis with loss of function is the primary reason for hip and knee arthroplasty.

• Total hip and knee replacements annually are 450,000 and 720,000 respectively. • TJR client benefits tremendously from exercise using a structured protocol-based program.

Health care systems are buckling under the costs and numbers of individuals with chronic diseases


Standard Treatment … Just Doesn’t WorkThe standard treatment of “The Big 5” includes:

• Drug therapy • Short bouts of physical therapy or chiropractic care• Temporary pain relief and restoration of low-level function


A structured protocol-based approach to exercise is an effective option for

these conditions/procedures.

1. Specific functional outcome measures to gauge progress and effectiveness (i.e. blood pressure & A1c)

2. Protocol-based approach containing specific exercise progressions and documentation/communication guidelines designed for individual medical conditions

3. Finite with specific guidelines on frequency and duration (i.e. 2x per week x 8 weeks)

4. Engage clients in home exercise and lifestyle education

5. Medical Exercise Training


The New Fitness Approach

What Is Medical Exercise Training? (MET)Development of Safe and Effective Exercise Programming for Individuals with Medical Conditions


Cardiovascular Training

Strength Training

Flexibility Training

Medical Condition-Based Protocols

All About Functional Outcomes!!• Glycosolated Hemoglobin (A1c) – DM• Blood Pressure – HTN• Blood Glucose – DM• Bone Density – OA, Osteoporosis• Range of Motion – TJR, OA• Muscle Strength Testing – OA, TJR• Functional Assessment Scale – all conditions• Cholesterol Levels – HTN, DM, Obesity• Pain Scale – LBP, OA, TJR• Anthropometric Measures – Obesity• Resting Heart Rate – HTN, DM• Body Mass Index – Obesity, HTN, DM, TJR


The New Modality – Medical Exercise Training• The development of safe and effective, structured, protocol-

based exercise programming specific to a medical condition

• Focuses on strength, flexibility, cardiovascular endurance, balance, and stability

• Cardiovascular, neurological, metabolic and musculoskeletal disorders benefit from MET

• Uses “functional outcome measures” to determine the effectiveness of the exercise

“MET does not provide any aspect of medical diagnosis or treatment.”


Medical Exercise Training is beneficial for the following conditions/procedures:

Osteoarthritis Diabetes

Hypertension

Lumbar Disc Herniation Total Hip Replacement Total Knee Replacement

Achilles Tendon Rupture Plantar Fasciitis

Cervical Strain

Laminectomy Spinal Fusion

Osteoporosis

Shoulder Impingement Rotator Cuff Tear Meniscal Tear

Shoulder Dislocation Cerebrovascular Accident Carpal Tunnel

Syndrome

Rheumatoid Arthritis Parkinson’s Disease

Lateral Epicondylitis

Medial Epicondylitis Thoracic Outlet Syndrome IT

Band Syndrome

Tibial Plateau Fracture Closed Head Injury Ankle Fracture

Ankle Sprain AC Joint Separation

Bicipital Tendinitis

PCL Rupture MCL Sprain LCL

Sprain

Spondylolethesis Ankylosing Spondylitis Brachial Plexus

Strain

ACL Rupture/Reconstruction Greater Trochanteric Bursitis Cervical Disc Herniation

Piriformis Syndrome Patello-Femoral Syndrome

Spinal Stenosis

Lupus Erythematosus Frozen Shoulder

Patella Tendon Rupture

Cerebral Palsy Myocardial Infarct

Obesity

Patelloectomy Total Shoulder Replacement

Cancer


New Health Care Professional – Medical Exercise Specialist• MET services are provided by “Medical Exercise Specialists” (MES)

• The MES is not a “personal trainer”

• Each MES is trained in the management of medical conditions using a protocol-based approach to exercise

• The MET protocols are the basis of every aspect of MET services


• Deliver safe and effective exercise for medical conditions

• Effectively communicate with medical professionals

• Provide recommendations on exercise for medical conditions

• Document functional outcome measures

• Provide wellness and lifestyle education

www.medicalexercisespecialist.com


Role of the Medical Exercise Specialist

Medical Exercise Training Client• Average MET client is 25 – 80 years of age

• Has a “medically-stable” chronic condition that may ranging from obesity to a total joint replacement

• Has a referral from a physician or medical professional

• 2 -3 times per week for 8 – 12 weeks

• Each session consists of strength, cardiovascular, stability, balance and flexibility training


• One-on-One MET sessions are available for all conditions. Condition specific sessions are delivered in a private setting and are either 30 or 60 minutes in length. For those who want schedule flexibility and need more personalized attention, this is an ideal program.

• Small group MET (SGMET) is the most economical option. SGMET is particularly useful in managing clients on a fixed income. SGMET is available for clients with similar conditions. SGMET sessions consist of 2 to 4 clients.

• “MED-FIT” training classes are available for 1. low back pain, 2. diabetes & hypertension and 3. total joint replacements. The classes are the “lifestyle” component of MET services. MED-FIT sessions consist of 45 minutes of condition-based exercise and 15 minutes of lecture on a point of importance related to the condition. These classes are delivered to groups of 4 to 10 participants.


Medical Exercise Training Options

• Group-based “MED-FIT” training classes are available for:

• MED-FIT classes include 6 sessions consisting of 45 minutes of condition-based exercise and 15 minutes of lecture on a point of importance

• Each class consists of 4 to 10 participants


MED-FIT Educational Classes:

Medical Exercise Training Process1. Complete a thorough medical history

2. Complete the “musculoskeletal screening”

3. Complete regional MED-FIT Assessment

4. Summary of MET program communicated to referral source

5. Progress report forwarded to referral source every 30 days

6. MET session documented in the client’s file


Integration of Medical Exercise ManagementThe importance of exercise is abundantly clear. Integration of exercise into medical management has been slow to occur. MET is designed to work in conjunction with medical professionals.


For more information on Medical Exercise Training, Certifications, Guidelines and Protocols, please contact:

Dr. Michael K. Jones, PhD, PT

22136 Westheimer Pkwy #349

Katy, TX 77450

1.888.610.0923

[email protected]

www.PostRehab.com


Medical Exercise: The New Modality

Health & Medicine

Transcript of Medical Exercise: The New Modality